Polycystic ovary syndrome

PCOS is one of the most common causes of female infertility. Polycystic Ovarian Syndrome occurs when the follicles within the ovary's grow but fail to burst open and send the egg through the ovarian wall. The follicles are tiny, fluid-filled sacs that hold the eggs. When an egg is mature, the follicle breaks open to release the egg so it can travel through the fallopian tubes where, if trying to get pregnant it hopefully is met and fertilized by the sperm. It then travels to the uterus where implantation on the uteran lining occurs.

In women with PCOS, when follicles fail to release the egg, the egg gets stuck inside the ovary and cysts grow over the area where the egg is unsuccessfully trying to push through. As a result, women with PCOS often have irregular menstrual cycles. Because the eggs are not released, ovulation does not occur or occurs very irregularly leading to difficulty in getting pregnant and sometimes infertility. Researchers estimate that 5 percent to 10 percent of women in the United States have PCOS.

Women with PCOS may also have other symptoms, such as insensitivity to insulin, obesity, high blood pressure, and hersutism (excessive hair growth). Some studies show that PCOS can lead to diabetes, heart disease and ovarian cancer.

Research has shown that a cause for PCOS may be linked to an insensitivity to insulin which makes the body think there is not enough. To compensate, the body creates excessive amounts of insulin. This excessive insulin somehow activates androgens or male hormones into over producing. It is the rise in the level of male hormones at the crucial stage of a women's cycle (mainly during the LH surge that preceeds ovulation) that supresses the ability for the female hormones to push the egg out of the ovary.

Recently some fertility doctors and reproductive endocrinologists have been perscribing insulin desensitizing drugs for people with PCOS. Drugs such as Metformin combined with the use of Chlomid, a commonly used ovulation stimulator, have proven to be effective treatment for women who want to get pregnant.

There are no studies showing other treatments are viable but many people with PCOS, doctors and other healthcare workers have said that there are other ways to treat the syndrome. Symptoms of PCOS do seem to abate when combining a healthy diet and increased excercise. (See Article on PCOS and Diet).

Although researchers are still trying to learn about this disease, and to find ways to treat the infertility associated with PCOS, there have been some promising leads. One group of NICHD-supported researchers may have found a possible treatment for the infertility related to PCOS. To learn more about this and other research findings, read the news releases on PCOS.

The NICHD's Reproductive Sciences Branch, through its Reproductive Medicine Network (RMN) is currently conducting a clinical trial for the treatment of infertility related to PCOS. The RMN Web site provides more information on this trial and on the RMN itself. In addition, the NIH is conducting a number of clinical trials on different aspects of PCOS.